Last Sunday for me was my worst nightmare come true. A real health emergency, my own! … something I had often thought about, but dreaded having to face.
Without going into too many details about my own health, on Saturday morning I was doing someone a good turn, and felt something go in my back (the mind may boggle here, but please don’t let it!). I knew straight away that was my weekend was written off, but it happens, and a day or two of rest normally does the trick. I had a ticket to go and watch the the Nacional v Sporting game that afternoon, so that was my biggest disappointment.
Anyway, come Saturday night I was in agony. My leg was almost paralised, my back was on fire, and to get to the loo involved sliding along the floor. Needless to say sleep was hard to come by, and by 6am on Sunday morning I realised my options had run out. I slid around the house gathering some things and got dressed and made that dreaded 112 call at 7am. Neither the first or second telephone operator spoke any English, but I am sufficiently able now to cope with that in the local dialect. The fire brigade (ambulance driver) rang 5 minutes later for directions, and within 10 minutes of the first call they had arrived, bringing a wheelchair as requested. With just a five minute ride to the local health centre, it was all off to a good start … if you can call agony a good start! And I was the first and only patient … even better. A quick chat with the duty doctor and it was down with the pants and in with the needle. There must of been 10 staff, including cleaners, even at that time of the morning. They were all very amused by the fact that I chose to sit on the floor (for reasons of comfort), one person pointing out that floor was a dirty place to sit … perhaps a surprising comment as she was the hospital cleaner. Anyway, after waiting 40 minutes or so, the injection had had no effect, so I was whisked back into the ambulance and off to Funchal Central Hospital accident and emergency department (or the equivalent of). The ambulance drivers and staff at Ribeira Brava were excellent, and nothing but praise up until arriving at FCH.
You will probably remember from a week or so ago I reported about the new computerised patient management system in FCH was causing some problems, and combined with high flu levels, the hospital was struggling, with some low priority patients waiting all day to be seen. But I had no need to worry, as having been transferred to another wheelchair by the ambulance crew, I was wheeled around to ‘triage’ and was seen within 5 minutes by the triage nurse. I was given the white sticker which was stuck on my shirt, and then wheeled around to the Orthopaedics (the A & E equivalent) department and put in a waiting area alone. First in line I thought great … pain relief just a few minutes away. For those who don’t remember, ‘green stickers’ are for higher priority patients, but as it happens that day they had run out of green stickers, so everyone had white, and those with higher priority had their sticker swiped with a yellow highlighter pen. Now these stickers are supposed to prioritise patients and provide security control for the hospital, but they in fact did neither, and instead gave the wearer a false sense of expectation about their health problem rating and hospital security. I spent around 6 hours without any sticker at all after a nurse took mine off. As for patient prioritising, the stickers seemed pretty meaningless, as the A & E staff worked from a handwritten list of names, which was added to when someone new came along. So if for example you were sent to X-ray by the doctor, it seemed that you then went to the back of the queue for the follow-up consultation.
Anyway, my dream of being first in the queue was soon dashed, as hospital in-patients were wheeled into A & E on their beds and in wheelchairs, and it was about an hour and a half before it was eventually my turn. I was then taken to see the one and only duty doctor, who told me I would need to go to X-ray before going any further. I begged to have some medication to help with the pain before I went, and he obliged with a drip medicine which took over an hour to get into me, but unfortunately had no effect whatsoever, and just delayed my trip to X-ray.
It was probably around midday when I went into X-ray, and that was very impressive with automated scanners flying around all over the room, but even so they were having trouble accommodating me as I was unable to leave my wheelchair and stand up straight. OK, up until this point I was still pretty impressed with how the day had gone so far, with lesser waits than I had expected, but still with expectations of being either admitted or sent home within a couple of hours, and maybe even getting a late lunch, as I had nothing so far that day. But that’s when it all started going wrong.
I was wheeled back from X-ray to A & E, to find a lot of new patients had arrived, and I was now at the back of the queue to be seen by the doctor. There were as many foreigners there as locals, mostly with twisted ankles and knocks from walking trips (or so it seemed judging by the big boots they were mostly wearing).
The doctor and his assistant were the only ones I came across all day who spoke any English. That was helpful as my sparse and broken Portuguese would have faired pretty badly in such important and technical conversations. Although the ambulance driver who later took me home also spoke English.
Digressing again for a moment, going to hospital for whatever reason is always a depressing affair, unless you work there, and one thing patients and visitors can take a little comfort in is the nurses, particularly and traditionally for men. I have to say that I was disappointed on this score to find that nurses, orderlies, and other staff were dressed in pastel green or blue, depending on status, and their uniforms of creased loose fitting jackets and trousers were very disappointing in the nurses uniform sense, and totally spoilt the one possible highlight of the day.
Anyway, after a long wait I eventually got back to see the doctor again, probably around 3pm. He showed me my X-ray and gave a diagnosis, and then sent me off to sit under another painkilling drip which lasted an hour or more, and unfortunately that again had no effect whatsoever. So back in to the doctor again for an injection into the rear end, and this time it did start to work and some partial relief was very very welcome. When I told the doctors assistant, he said OK, now we just need to get you a prescription and we are finished. He had already explained that their objective was to relieve the immediate pain, decide on the medicine needed, and get me discharged. Admission to the hospital was not a consideration in any circumstances, even though I explained I had no care for me back at home. He told me that the injection I had been given would be effective for UP TO 8 hours, which was quite critical to me getting home after getting to a pharmacy, and going straight to bed. I figured that as long as the pain relief lasted the full 8 hours, I had until midnight at the latest to get into bed at home having taken my prescribed medicine. That was not to be the way it worked out however.
I remember at about 6.30pm sitting in my wheelchair looking at my watch and thinking I am so hungry. I had been on the go since 7am, and nothing to eat or drink all day so far, but I was thinking that was just the way it worked, and I would have to just grin and bear it. Of course, had I not been in a wheelchair, and afraid of missing my next slot, that somewhat limited my options to go and seek refreshment myself. I could have easily left over two hours earlier, I wa
s just waiting for that bit of paper I needed to take to the pharmacy. The place was pretty busy by now, and I tuned into a group conversation from some dissatisfied patients who thought they had been waiting too long and were unhappy with the prioritising system and people getting seen out of turn. My opportunity to chip in arose, and I proudly informed them that I had been there since 9am (at least 3 hours longer than anyone else still remaining) and had not even had a glass of water so far that day. Stunned silence and disbelieving expressions ensued, but it must of sunk in somewhere, because it must have been mentioned to a member of staff, as within half an hour I was presented with a bowl of lukewarm and pretty tasteless vegetable soup. Nether-the-less I devoured it in seconds, grateful for anything at that point.
At around 6pm the customary cackling old woman arrived, strapped to her trolley-bed. At first people found her amusing, as did I, as she cackled non stop at full volume. The nurses tried numerous times to get her to shut up, to no avail, and after a couple of hours subjected to that the general feeling of depression was increased for all. She was still in full flow when I left 5 hours after she came in. She, like other old people, were coming in accompanied by several relatives taking up the waiting area seats so the real patients couldn’t get a seat. It seems that taking granny to hospital is treated as a bit of a family day out.
Digressing again, Funchal Central Hospital is a bit of a tired looking place decor wise, but it was clean, spacious, reasonably maintained, and seemed to have everything it needed, for dealing with me at least.
My last ‘drip’ was completed at around 4pm, but at 7pm I still had the needle sticking out of my arm. I had to ask 3 times to have it removed before someone eventually came and did it. I had said to two staff members during the early afternoon that if I was going to be discharged then I would need assistance to get home, including the use of a wheelchair. It was made pretty clear early on that the objective was to discharge me once a way had been found to deal with the immediate pain, and that relief happened at around 4pm. The ambulance to take me home didn’t arrive to pick me up until nearly 11pm. There was one man who seemed to be in charge of organising this, and for sure he wasn’t using a computerised system, and whether cash passed hands to jump the queue I couldn’t say. But at one time in desperation I wheeled myself out to the ambulance pick up point to plead for the next ambulance out, but this man told me I couldn’t wait outside, and against my will wheeled me back to the A & E waiting area.
Eventually I was told my ambulance was ready, 14 hours after arriving that morning and nearly 7 hours after my treatment and consultations were complete. I bit my tongue throughout and wasn’t rude and didn’t complain, and whether that worked in my favour or not I will never know. Unfortunately I was so late leaving, that the pharmacies were closed and as a result I didn’t get my pain relief medicine until the following afternoon. In the meantime the effects of the injection at around 4pm had long since worn off, so I ended up going home in as much pain as when I had started out that morning. The ambulance staff were excellent though, and wheeled me and then carried me to where I needed to be next to my bed at home.
So, after my 14 hour visit, just to really get an injection and prescription, was I impressed? Not really. I think the facilities are acceptable, and the staff were able, pleasant and accommodating, and the disappointing soup was a minor concern that could be overcome with a little sachet of salt and access to a microwave oven. The lack of attractive staff uniforms were a much greater concern however, as without a pretty nurse or two the whole experience is a total downer, and I don’t think low patient morale is not a good recipe for speedy recovery. The fact that there was only one doctor available is another concern, and makes the department name ‘Urgencies’ somewhat meaningless. The organisation of patients however was totally unacceptable, from the worthless sticker scheme right through to leaving the hospital. But that is what this new computerised system is supposed to address, so perhaps my ‘accident’ just occurred at the wrong time.
Maybe I was just unlucky with my own situation, but I can only reiterate that I was in extreme pain for many hours. To send me home when the only effective pain relief treatment had worn off was unacceptable, and possibly dangerous. Given my circumstances they should have kept me in overnight at least.
Anyway, just to finish up, I would say that I was so glad that my little bit of substandard Portuguese was so useful. Without it I probably couldn’t even have summoned an ambulance, let alone understood what was going on at the hospital, which would otherwise at the very least been confusing, if not even more scary.
BTW – Snow here again in the high zones, and Tobi sent in this video link :
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